急性上消化道出血112例临床疗效分析

采用国家中医药管理局颁布的《中医血证治疗常规》治疗急性上消化道出血112例，取得了较好疗效，总有效率达94．6％。进行了证和疗效，原发病和疗效，病情程度和疗关系的分析。说明中医血证治疗效常规在临床实践中是切实可行的。     

Prenatally detected cystic neuroblastoma

A case of adrenal cystic neuroblastoma (NB) detected by prenatal ultrasonography (US) is presented. The suprarenal mass initially showed pure cystic features on a variety of imaging studies such as US, computed tomography, and magnetic resonance imaging. Tumor markers were negative. The mass was suspected to be an adrenal hemorrhage rather than a NB. Three months later, although the diameter was unchanged, the thickness of the cyst wall seemed to have slightly increased. Surgical exploration revealed an adrenal cystic tumor and histology showed a NB in situ. Forty-five infants with prenatally detected NB were found in the English literature; about one-half of them were cystic NBs, and most had a favorable outcome. Accepted: 29 July 1996     

刺五加注射液治疗脑出血的临床评价

30例高血压脑出血患者在常规疗法基础上加用紫外线辐射血液疗法作为对照组,另30例在上述疗法基础上加用刺五加注射液静脉滴注为治疗组。结果治疗组显效率96.7％,总有效率100％,对照组显效率60.0％,总有效率83.3％,治疗组明显优于对照组(P<0.01)。表明刺五加注射液不仅用于缺血性脑梗塞的治疗,而且也可用于脑出血,对出血量在30ml以下的病例,疗效较好。     

七叶皂苷钠佐治脑出血的研究

目的观察七叶皂苷钠治疗脑出血脑水肿的疗效及安全性。方法将40例脑出血患者随机分为2组,治疗组21例,对照组20例,均应用甘露醇脱水降颅压,治疗组加用七叶皂苷钠。治疗前后进行神经功能评分,CT下测量水肿体积。结果治疗后治疗组神经功能评分明显高于对照组(P<0.05),治疗组水肿产生量明显少于对照组(P<0.05)。结论脑出血急性期加用七叶皂苷钠可以抑制脑水肿的形成,提高脑出血患者神经功能评分。     

急性脑血管病患者心肌酶谱改变及临床意义

目的 探讨急性脑血管病（ACVD）患者血清心肌酶谱改变及其临床意义.方法 检测发病1周内ACVD患者血清心肌酶谱即谷草转氨酶（AST）、乳酸脱氢酶（LDH）、肌酸激酶（CK）,同时进行神经功能缺损程度评分（SSS）与对照组对比分析.结果 脑出血（ICH）组和脑梗死（CI）组的血清心肌酶谱均高于对照组（P＜0.05）.ICH组的心肌酶谱高于CI组（P＜0.05）.脑卒中病变部位不同心肌酶谱改变发生率有差异.有颞叶损害组心肌酶谱高于无颞叶损害组（P＜0.05）,有丘脑损害组心肌酶谱高于无丘脑损害组（P＜0.05）.LDH水平与SSS评分呈正相关（P＜0.05）.结论 ACVD患者存在明显的心肌酶谱改变,检测其血清心肌酶谱有助于病情轻重及预后判断.     

不同置换量对蛛网膜下腔出血脑脊液置换疗效的影响

目的 观察不同置换量对蛛网膜下腔出血脑脊液置换疗效的影响。方法 将60例患者随机分为A组（大量脑脊液置换组）30例、B组（小量脑脊液置换组）30例。对A、B组腰椎穿刺用三通管行脑脊液置换，置换总量A组50～70ml做，B组10～30ml／次。结果头痛缓解时间A组〈B组（P〈0．01）；继发脑血管痉挛、脑积水的发生率A组〈B组（P〈0．05），但再出血的发生率两组差异无显著意义（P〉0．05）；总有效率A组〉B组（P〈0．05）。结论 早期大量脑脊液置换治疗蛛网膜下腔出血的效果优于小量脑脊液置换，但都不能减少再出血的发生。     

Phenytoin administration reveals a differential role of pontine reticular formation and periaqueductal gray neurons in generation of the convulsive behaviors of audiogenic seizures

The ventrolateral periaqueductal gray (PAG) and pontine reticular formation (PRF) are implicated in the neuronal network for audiogenic seizures (AGS). The AGS of genetically epilepsy-prone rats (GEPR-9s) culminate in tonic hindlimb extension (TE), and elevated acoustically evoked neuronal firing and burst firing, immediately preceding TE, have been observed in PAG and PRF. This study examined changes in PAG and PRF neuronal firing and behavior in GEPR-9s, following phenytoin administration. Recordings involved 16 PAG and nine PRF neurons in GEPR-9s. Phenytoin in doses (mean, 6. 3 mg/kg) that suppressed TE selectively did not consistently alter PAG neuronal firing. However, these doses of phenytoin resulted in significant (51.6% of control) suppression of PRF neuronal firing. Doses of phenytoin (mean, 8.3 mg/kg), which completely blocked AGS, significantly reduced PAG neuronal firing (64.6% of control), and more greatly suppressed PRF firing (25.8% of control). These results are consistent with a critical role for PRF neurons in generation of TE not evident for PAG. The suppression of PAG and PRF neuronal firing induced by phenytoin with complete seizure blockade is consistent with vital roles for both structures in the seizure network. The differential effects of phenytoin on structures requisite to the seizure network indicate that this experimental approach may be able to identify the most sensitive therapeutic target for anticonvulsant drugs, which could be critical to pharmacological suppression of specific seizure behaviors manifest in various types of convulsions, potentially including human epilepsy.     

The Effect of Tizanidine on Chronic Vasospasm in Rats

Summary ? Background. Cerebral vasospasm after subarachnoid hemorrhage (SAH) has remained a major cause of morbidity and mortality in patients with SAH. Excitatory neurotransmitters are gathered in the extracellular space during ischemia due to cerebral vasospasm and initiate or stimulate a series of pathophysiological biochemical processes which consequently lead to neuronal death. Tizanidine (Sandoz compound DS 103–282, 5-chloro-4,2 (2-imidazolin-2-yl-amino)-2,1,3-benzothiazol hydrochloride) is a centrally-acting muscle relaxant and a selective α 2 adrenoreceptor agonist which shows its effect by stimulating presynaptic α 2 adrenoreceptors in central ASPergic and GLUergic system by inhibiting aspartic acid and glutamic acid release. In this study, the effect of Tizanidine on vasospasm was evaluated.  Methods. We used a femoral artery vasospasm model in rats which has been described by Okada et al. 60 rats were examined in three groups. The first group was used as control group (Control) (n=20), in the second group subarachnoid hemorrhage was performed (SAH) (n=20), in the third group Tizanidine was administered in addition to SAH (SAH+Tizanidine administration) (n=20). Animals in SAH+Tizanidine administration group received 0,3 mg/kg/day intraperitoneally for 7 days. Seven days after the experiment, after perfusion-fixation, 10 mm segments of both femoral arteries were removed and the femoral artery was prepared for light microscope examination, scanning and transmission electron microscopy and for morphometric analysis.  Results. There was a statistically significant difference between the electron, scanning and light microscopic observations and morphometric analysis of SAH+Tizanidine administration group and SAH group, and no statistically significant difference between SAH+Tizanidine administration group and control group.  Conclusion. This study has disclosed that Tizanidine administration before the vasospasm reduces ultrastructural and morphometric vasospastic insult significantly. However, the clinical application of Tizanidine as a protective and therapeutic agent in cerebral vasospasm needs further studies including the employment of clinically more relevant SAH models.     

Delayed Administration of the K+ Channel Activator Cromakalim Attenuates Cerebral Vasospasm after Experimental Subarachnoid Hemorrhage

Summary ? Background. Delayed cerebral vasospasm remains an unpredictable and inadequately treated complication of aneurysmal subarachnoid hemorrhage (SAH). Recent evidence indicates that the potassium channel activator cromakalim is capable of limiting cerebral vasospasm in rabbits when administered immediately after experimental SAH (i.e. before spastic constriction has been initiated). However, the ultimate clinical value of cromakalim for treating vasospasm will depend in part on its effectiveness when administered after SAH-induced constriction has already been initiated. The present study examined the effects of cromakalim on vasospasm when treatment was initiated after SAH-induced constriction was underway.  Methods. New Zealand white rabbits were subjected to experimental SAH by injecting autologous blood into the cisterna magna. Cromakalim (0.03, 0.1 or 0.3 mg/kg) or vehicle was injected intravenously at 8 hour intervals beginning 24 hours post-SAH. Animals were killed by perfusion fixation 48 hours after SAH. Basilar arteries were removed and sectioned, and cross-sectional area was measured.  Findings. The average cross sectional areas of basilar arteries were reduced by 64% and 68% in the SAH-only and SAH+vehicle groups, respectively. Treatment with cromakalim dose-dependently attenuated SAH-induced constriction. The groups treated with 0.03, 0.1, and 0.3 mg/kg cromakalim exhibited average decreases in cross-sectional area of 57%, 42%, and 19%, respectively.  Interpretation. These findings indicate that cromakalim dose-dependently attenuates cerebral vasospasm when administered 24 hours after experimental SAH in the rabbit. The results suggest K_ATP channel activators, such as cromakalim, could be of benefit for reversing cerebral vasospasm after aneurysmal SAH.     

腹腔血β-hCG定性诊断异位妊娠的探讨

目的:探讨以腹腔血β-hCG定性检测诊断异位妊娠的临床应用价值。方法:采用尿试纸法定性检测90例腹腔内 出血患者的腹腔血β-hCG,并与其尿β-hCG定性和血清β-hCG定量分析结果进行比较。结果:在74例异位妊娠中,腹腔血β-hCG 定性法5~10min能出结果,诊断异位妊娠的特异性为100.0％,敏感性为98.5％,准确性为99.0％。与血清β-hCG定量分析结果 基本一致,结合其他辅助方法能快速诊断异位妊娠,明显优于尿β-hCG定性检查。结论:对腹腔内出血患者采用腹腔血β-hCG定 性检测,能方便、快速和准确地诊断异位妊娠。